Information Collection

Geographic Preference Statement for Senior Administrative Law Judge Applicant

IC 182393 under ICR 202409-3206-001 · OMB 3206-0248.

Documents and Forms

Documents and forms in this information collection
Document Name	Document Type
Form OPM 1655-A Geographic Preference Statement for Senior Administrative Law Judge Applicant	Form and Instruction
Form OPM 1655-A Geographic Preference Statement for Senior Administrative Law Judge Applicant Geographic Preference Statement for Senior Administrative Law Judge Applicant	Form and Instruction
OPM 1655-A Geographic Preference Statement for Senior Administrativ OPM Form 1655-A (2027).pdf	Form and Instruction
OPM 1655-A Geographic Preference Statement for Senior Administrativ OPM Form 1655-A (2027).pdf	Form and Instruction
OPM Form 1655-A - Track Changes.pdf OPM Form 1655A with track changes	IC Document
OPM Form 1655-A - Track Changes.pdf OPM Form 1655A with track changes	IC Document

IC Title:

Agency IC Tracking Number:

Is this a Common Form? No

IC Status: Modified

Obligation to Respond: Voluntary

CFR Citation: 5 CFR 930.201

Information Collection Instruments:

table that charts list of instruments
Document Type	Form No.	Form Name	Instrument File	URL	Available Electronically?	Can Be Submitted Electronically?	Electronic Capability
Form and Instruction	OPM 1655-A			opm.gov	Yes	Yes	Fillable Fileable

Line of Business: General Government

Subfunction: Central Personnel

Privacy Act System of Records

Title: OPM Central 6

FR Citation: 60 FR 63084

Number of Respondents: 200

Number of Respondents for Small Entity: 0

Affected Public: Individuals or Households

Percentage of Respondents Reporting Electronically: 0 %

table that charts list of burden
	Approved	Program Change Due to Agency Discretion	Previously Approved
Annual Number of Responses for this IC	200	0	200
Annual IC Time Burden (Hours)	83	16	67
Annual IC Cost Burden (Dollars)	4,844	1,556	3,288

Documents for IC

table that charts IC Documents
Title	Document	Date Uploaded
OPM Form 1655A with track changes		06/25/2018

Blank fields in records indicate information that was not collected or not collected electronically prior to July 2006.

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